Advanced imaging techniques in the staging of intracranial mass contribution

Purpose MRI is the most sensitive imaging method of displaying anatomic details of the brain for imaging the intracranial mass lesions. Contrast-enhanced MRI is the preferred radiological method for brain tumor diagnosis, local staging and follow-up after treatment. Contrast-enhanced MRI data is not always enough for the pre-treatment staging of brain tumors. Recent studies in neuroradiology made physiological mapping possible, besides obtaining conventional anatomic details through MRI. Diffusion MRI, perfusion MRI and MR spectroscopy are considered to be among these advanced imaging methods. In glial tumors, histopathological grading supplies important information about the biological behavior of the tumor. Parallel to the obtained histopathologic degree of tumor, treatment protocols is determined. In this study, we aimed to investigate the contribution of advanced imaging methods for grading glial tumors. We tried to describe the relative contributions and limitations of advanced imaging methods by comparing the findings that are obtained through these methods in histopathologically diagnosed cases. Materials and Method In our study, MRI, diffusion MRI, perfusion MRI and MR spectroscopy have been applied to 36 cases who had preliminary diagnosis of intracranial mass between January 2010 and June 2013 using GE Signa hdx1, 5 Tesla MRI device. All of the patients have been selected among primary; which means untreated patients. Sagittal T1-FLAIR ASSET, axial T2-FRFS to, axial T2-FLAIR, axial T1-weighted SE, b value of 1000 in the DAG, coronal T2-FRFS A, axial T2-FRFS the 3D BRAVO MASK, MV (2D) TE: 144, MV (2D) TE: 35, axial GRE perfusion, post-contrast axial spin echo T1-coronal sequences were used as routine shooting parameters. Statistically SPSS (Statistical Package for Social Sciences) for Windows 15.0 programme and ANOVA Post Hoc Test, Kruskall Wallis Test, NPar Test, Mann-Whitney Test ve T Test was used. Findings The ADC values of grade 2 tumors and grade 4 tumors are statistically significant in differring the two tumors. Also in perfusion MRI CBV values are statistically significant for the differentiation of grade 2 and grade 4 tumors. MR Spectroscopy findings showed the significance of LL in differing the grade 2 and 4 tumors, in addition grade 3 and grade 4 tumors. Conclusion The three methods; diffusion MRI, perfusion MRI and MR spectroscopy, that we used for grading glial tumors in 36 cases which had been histopathologically diagnosed, have been determined to be contributing to grading in various areas and we came to the conclusion that more efficient data about grading can be obtained by the company of these methods to conventional inspection. Key Words: Intracranial mass, MRI, diffusion weighted imaging, perfusion MRI, MR spectroscopy